Email Advice: Adult Lisp

By Pam Marshalla

I receive many requests from adults who are seeking help for their minor articulation problems. They find me on the web and write to me asking what they should do. (Sometimes I worry these folks are secret “anti-oral-motor people” writing to catch me doing unethical therapy via email so they can shut me down somehow… That’s the paranoid side of me. But usually I believe that these are honest people who genuinely are seeking advice.) The following is a typical question…

Oral Awareness is Only a PIECE of the Big Picture

By Pam Marshalla

Q: I attended a workshop of yours and recall the recommendation to have the student brush the sides of the tongue to elicit the R sound. I can’t find the method in your handout. Where is it? It is SOOOOOOOO critically important to understand the PURPOSE of a method! One does not brush the sides of the tongue to elicit R and I would NEVER recommend that. Instead one brushes the sides of the tongue to AWAKEN the tactile system there. …

Beginner Oral Motor Info

By Pam Marshalla

Q: Where can I find out about oral-motor therapy? The best place to begin learning about oral motor techniques is from reading what has been written in books and online.  Search online under oral-motor.  May I recommend the following beginning points–– This blog’s oral-motor category The articles posted at the Oral Motor Institute website The resources made by Talk Tools International Debra Beckman’s Resources SpeechLanguageFeeding.com

Basic Elements of Motor Speech Therapy

By Pam Marshalla

Q: My male client is six and he has had phonological therapy for three years with another therapist. He was switched to me because he was going nowhere, and now he is going nowhere with me. I think he needs a motor approach but I have no idea how to begin. Can you guide me? Yours is a very common dilemma: You have tried basic phonological therapy that is auditory/cognitive/linguistic in nature and found that your client is not doing…

SmartPalate

By Pam Marshalla

Q: Have you tried the SmartPalate? I am considering trying it with a few clients who have stubborn sound errors. I would like some input from people who used it first. The SmartPalate is a clinical electropalatometry tool and I have not used it. I have read all about it, however, and I am sure it will be very useful for some clients, but there are ways to do this without the expense. The SmartPalate provide visual feedback about place of articulation,…

Mirror Play for Breath Work

By Pam Marshalla

Q: I have discovered that a mirror helps my young clients understand the idea of breath support for speech. Kids notice that their breath makes a fog on a mirror. I teach them to make longer and longer exhalations to make more and more fog and then they draw smiley faces in the fog on the mirror. Fun! Can you comment? My reading of historic artic books has revealed to me that we all end up developing the same methods…

Diagnosing Apraxia in Toddlers

By Pam Marshalla

Q: I received a referral for a 15-month-old diagnosed by a private SLP with apraxia. The child has excellent receptive language and produces 10-15 words. I was told that the child was an “automatic qualifier” coming in with the diagnosis of apraxia. I have huge reservations with this and do not feel as if the diagnosis was made appropriately in just in one session and not over time. There are no indications of motor difficulties elsewhere. Am I out in…

Muscle Problem vs. Cognition Level

By Pam Marshalla

Q: My 5-year-old daughter has below average intelligence and she can say Bah, Mah, S, Da, and Nnn, but no real words. She has had speech therapy for two years. Could you suggest an oral appliance that can help her to improve oral muscles and tongue movement awareness? I am going to be very blunt here, and probably more straight forward than I would in a real therapy session in which I would gently lead you toward this idea over…

S and Z Tongue-Tip Facilitation

By Pam Marshalla

Q: My client has no back sounds, and he substitutes Sh and Ch for S. I cannot get a good S out of him. I have tried straws and the Ts technique you talk about, but he always makes a Sh or Ch. What do you think I should try next? I think you should try putting more attention on his tongue-tip to stimulate S and Z. The following excerpt about improving awareness and control of the tongue-tip is from…

Moving Across Syllables / Trial-and-Error

By Pam Marshalla

Q: Do you like the “Moving Across Syllables” program? My supervisor says it works. All methods work for the right client at the right time. All you can do is try and see. If it works for him, it works.  If not, perhaps it will work later on, or perhaps you need to find a different plan for him. The old-timers called this “trial-and-error.” Trial-and-error is not old-fashioned or out-of-step with modern therapy. It is the basis of what we do every…